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The role of glutamine in maintaining a healthy gut and supporting the metabolic response to injury and infection

  • Wiley W. Souba
    Correspondence
    To whom reprint requests should be addressed at Dept. of Surgery, Box J-286, University of Florida College of Medicine, Gainesville, FL 32610.
    Footnotes
    Affiliations
    Division of Surgical Metabolism, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA

    Department of Surgery, Veterans Administration Medical Center, Gainesville, Florida 32610 USA
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  • V.Suzanne Klimberg
    Affiliations
    Division of Surgical Metabolism, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA

    Department of Surgery, Veterans Administration Medical Center, Gainesville, Florida 32610 USA
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  • Donald A. Plumley
    Affiliations
    Division of Surgical Metabolism, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA

    Department of Surgery, Veterans Administration Medical Center, Gainesville, Florida 32610 USA
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  • Rabih M. Salloum
    Affiliations
    Division of Surgical Metabolism, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA

    Department of Surgery, Veterans Administration Medical Center, Gainesville, Florida 32610 USA
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  • Timothy C. Flynn
    Affiliations
    Division of Surgical Metabolism, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA

    Department of Surgery, Veterans Administration Medical Center, Gainesville, Florida 32610 USA
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  • Kirby I. Bland
    Affiliations
    Division of Surgical Metabolism, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA

    Department of Surgery, Veterans Administration Medical Center, Gainesville, Florida 32610 USA
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  • Edward M. Copeland III
    Affiliations
    Division of Surgical Metabolism, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA

    Department of Surgery, Veterans Administration Medical Center, Gainesville, Florida 32610 USA
    Search for articles by this author
  • Author Footnotes
    1 Supported by NIH Grant 1 R29 CA45327-01A1 and a grant from Veterans Administration Merit Review Board.
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      References

        • Alverdy J.
        • Aoys E.
        • Moss G.
        Total parenteral nutrition promotes bacterial translocation from the gut.
        Surgery. 1988; 104: 185
        • Ardawi M.S.M.
        • Newsholme E.A.
        Glutamine metabolism in lymphocytes of the rat.
        Biochem J. 1982; 208: 743
        • Baskerville A.
        • Hambleton P.
        • Benbough J.E.
        Pathologic features of glutaminase toxicity.
        Brit. J. Exp. Pathol. 1980; 61: 132
        • Border J.R.
        • Hassett J.
        • Laduca J.
        • et al.
        The gut origin septic states in blunt multiple trauma (ISS = 40) in the ICU.
        Ann. Surg. 1987; 206: 427
        • Cuthbertson D.P.
        Alterations in metabolism following injury: Part I.
        Injury. 1980; 11: 175
        • Deitch E.A.
        • Maejima K.
        • Berg R.
        Effect of oral antibiotics and bacterial overgrowth on the translocation of the GI tract microflora in burned rats.
        J. Trauma. 1985; 25: 385
        • Fox A.D.
        • Kripke S.A.
        • Berman J.M.
        • et al.
        Dexamethasone administration induces increased glutaminase specific activity in the jejunum and colon.
        J. Surg. Res. 1988; 44: 391
        • Fox A.D.
        • Kripke S.A.
        • DePaula J.
        • et al.
        Effect of a glutamine-supplemented enteral diet on methotrexate-induced enterocolitis.
        JPEN. 1988; 12: 325
        • Frisell W.R.
        Synthesis and Catabolism of Nucleotides.
        in: Human Biochemistry. Macmillan Co, New York1982: 292-304
        • Geer R.J.
        • Williams P.E.
        • Lairmore T.
        • et al.
        Glucagon: An important stimulator of gut and hepatic glutamine metabolism.
        Surg. Forum. 1988; 38: 27
        • Grant J.
        Use of L-glutamine in total parenteral nutrition.
        J. Surg. Res. 1988; 44: 506
        • Guzman G.
        • Bonsack M.
        • Liberty J.
        • et al.
        Abdominal radiation causes bacterial translocation.
        J. Surg. Res. 1989; 46: 104
        • Hammargvist F.
        • Wernerman J.
        • Ali R.
        • et al.
        Addition of glutamine to total parenteral nutrition after elective abdominal surgery spares free glutamine in muscle, counteracts the fall in muscle protein synthesis, and improves nitrogen balance.
        Ann. Surg. 1989; 209: 455
        • Hwang T.L.
        • O'Dwyer S.T.
        • Smith R.J.
        • et al.
        Preservation of small bowel mucosa using glutamine-enriched parenteral nutrition.
        Surg. Forum. 1987; 38: 56
        • Jacobs D.O.
        • Evans D.A.
        • Mealy K.
        • et al.
        Combined effects of glutamine and epidermal growth factors (EGF) on GI mucosal cellularity.
        Surgery. 1988; 104: 358
        • Jacobs D.O.
        • Evans A.
        • O'Dwyer S.T.
        • et al.
        Disparate effects of 5-fluorouracil on the ileum and colon of enterally fed rats with protection by dietary glutamine.
        Surg. Forum. 1987; 38: 45
        • Jepson M.M.
        • Bates P.C.
        • Broadbent P.
        • et al.
        Relationship between glutamine concentration and protein synthesis in rat skeletal muscle.
        Am. J. Physiol. 1988; 18: E166
        • Klimberg V.S.
        • Souba W.W.
        • Dolson D.J.
        • et al.
        Oral glutamine supports crypt cell turnover and accelerates intestinal healing following abdominal radiation.
        JPEN. 1989; 13 (Suppl.)
      1. Klimberg, V. S., Souba, W. W., Hautamaki, R. D., et al. Oral glutamine supports gut metabolism and structure, promotes “bowel resuce,” improves survival, and decreases morbidity following abdominal radiation. Submitted for publication.

        • Klimberg V.S.
        • Souba W.W.
        • Dolson D.J.
        • et al.
        Prophylactic glutamine protects the intestinal mucosa from radiation injury.
        in: Presented at the American Radiation Society Annual Meeting. April 1989 (In review)
        • Klimberg V.S.
        • Souba W.W.
        • Hautamaki R.D.
        • et al.
        Alterations and adaptations in intestinal glutamine metabolism following massive small bowel resection.
        in: Presented at the Society for Surgery of the Alimentary Tract Annual Meeting. May 1989 (Submitted for publication)
        • Leighton B.
        • Curi R.
        • Hussein A.
        • et al.
        Maximum activities of some key anzymes of glycolysis, glutaminolysis, Krebs cycle and fatty acid utilization in bovine pulmonary endothelia cells.
        FEBS Lett. 1987; 225: 93
        • Maddaus M.A.
        • Wells C.L.
        • Platt J.L.
        • et al.
        Effect of T-cell modulation on the translocation of bacteria from the gut and mesenteric lymph node.
        Ann. Surg. 1988; 123: 309
        • Marshall J.C.
        • Christou N.V.
        • Horn R.
        • et al.
        The microbiology of multiple organ failure.
        Arch. Surg. 1988; 123: 309
        • Miller B.M.
        • Cersosimo E.
        • McRae J.
        • et al.
        Interorgan relationships of alanine and glutamine during fasting in the conscious dog.
        J. Surg. Res. 1983; 35: 310
        • Mochizuki H.
        • Trocki O.
        • Dominioni L.
        • et al.
        Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding.
        Ann. Surg. 1984; 200: 297
        • Newsholme E.A.
        • Crabtree B.
        • Ardawi M.
        Glutamine metabolism in lymphocytes: Its biochemical, physiological and clinical importance.
        Q. J. Exp. Physiol. 1985; 70: 473
        • Newsholme E.A.
        • Newsholme P.
        • Curi R.
        • et al.
        A role for muscle in the immune system and its importance in surgery, trauma sepsis, and burns.
        Nutrition. 1988; 4: 261
        • O'Dwyer S.T.
        • Scott T.
        • Smith R.J.
        • et al.
        5-fluorouracil toxicity on small intestinal mucosa but not white blood cells is decreased by glutamine.
        Clin. Res. 1987; 369a ([Abstract])
        • Okabe S.
        • Honda K.
        • Takeuchi K.
        • et al.
        Inhibitory effect of L-glutamine on gastric irritation and back diffusion of gastric acid in response to aspirin in the rat.
        Dig. Dis. Sci. 1975; 20: 626
      2. Plumley, D. A., Souba, W. W., Hautamaki, R. D., et al. Accelerated lung amino acid release in hyperdynamic sepsis surgical patients. Presented at the 8th Annual Meeting of the Surgical Infection Society, Denver, Colorado. In press.

      3. Plumley, D. A., and Souba, W. W. Glucocorticoids accelerate lung glutamine release. Manuscript in preparation.

        • Reitzer L.J.
        • Wice B.M.
        • Kennell D.
        Evidence that glutamine, not sugar, is the major energy source for cultured HeLa cells.
        J. Biol. Chem. 1979; 254: 2669
        • Rush B.F.
        • Sori A.J.
        • Murphy T.F.
        • et al.
        Endotoxemia and bactermia during hemorrhagic shock.
        Ann. Surg. 1988; 207: 549
        • Shive W
        • Snider R.N.
        • DeBiller B.
        • et al.
        Glutamine in treatment of peptic ulcer.
        Tex. Med. November 1957; 840
        • Souba W.W.
        Glutamine metabolism in catabolic states: Role of the intestinal tract.
        in: Thesis. Harvard School of Public Health, Department of Nutritional Biochemistry, June 1984
        • Souba W.W.
        Interorgan ammonia metabolism in health and disease: A surgeon's view.
        JPEN. 1987; 11: 569
      4. Souba, W. W., Klimberg, V. S., Sitren, H. S., et al. Beneficial effects of glutamine-enriched total parenteral nutrition on the gastrointestinal tract. Manuscript in preparation.

        • Souba W.W.
        • Smith R.J.
        • Wilmore D.W.
        Effect of glucocorticoids on glutamine metabolism in visceral organs.
        Metabolism. 1985; 34: 450
        • Souba W.W.
        • Roughneen P.T.
        • Goldwater D.L.
        • et al.
        Postoperative alterations in interorgan glutamine exchange in enterectomized dogs.
        J. Surg. Res. 1987; 42: 117
        • Souba W.W.
        • Scott T.E.
        • Wilmore D.W.
        Intestinal consumption of intravenously administered fuels.
        JPEN. 1985; 9: 18
        • Souba W.W.
        • Smith R.J.
        • Wilmore D.W.
        Glutamine metabolism by the intestinal tract.
        JPEN. 1985; 9: 608
        • Souba W.W.
        • Strebel F.R.
        • Bull J.M.
        • et al.
        Interorgan glutamine metabolism in the tumor-bearing rat.
        J. Surg. Res. 1988; 44: 720
        • Souba W.W.
        • Wilmore D.W.
        Postoperative alteration of arteriovenous exchange of amino acids across the gastrointestinal tract.
        Surgery. 1983; 94: 342
        • Souba W.W.
        • Wilmore D.W.
        Gut-liver interaction during accelerated gluconeogenesis.
        Arch. Surg. 1985; 120: 66
        • Souba W.W.
        • Roughneen P.T.
        • Goldwater D.L.
        • et al.
        Effects of enterectomy on postoperative visceral organ glucose exchange.
        JPEN. 1989; 13: 128
      5. Souba, W. W., Klimberg, V. A., Hautamaki, R. D., et al. Oral glutamine reduces bacterial translocation following abdominal radiation. In review.

        • Stehle P.
        • Merter N.
        • Puchstein C.
        • et al.
        Effect of parenteral glutamine peptide supplements on muscle glutamine loss and nitrogen balance after major surgery.
        Lancet. February 4, 1989; 8632: 231
        • Van Saene H.F.K.
        • Stoutenbeek C.P.
        • Miranda D.R.
        • et al.
        A novel approach to infection control in the intensive care unit.
        Acta Anaesthesiol. Belg. 1983; 34: 193
        • Vinnars E.
        • Bergstrom J.
        • Furst P.
        Influence of the postoperative state on the intracellular free amino acids in human muscle tissue.
        Ann. Surg. 1975; 182: 665
        • Weber F.L.
        • Maddrey W.C.
        • Walser M.
        Amino acid metabolism of dog jejunum before and during absorption of keto analogues.
        Amer. J. Physiol. 1977; 232: E263
        • Welbourne T.
        Interorgan glutamine flow in metabolic acidosis.
        Amer. J. Physiol. 1987; 253: F1069
        • Welbourne T.
        • Childress D.
        • Givens G.
        Renal regulation of interorgan glutamine flow in metabolic acidosis.
        Amer. Physiol. Society. 1986; : R859
        • Wilmore D.W.
        • Smith R.J.
        • O'Dwyer S.T.
        • et al.
        The gut: A central organ after surgical stress.
        Surgery. 1988; 104: 917
        • Windmueller H.G.
        • Spaeth A.E.
        Respiratory fuels and nitrogen metabolism in vivo in small intestine of fed rats.
        J. Biol. Chem. 1980; 255: 107
        • Windmueller H.G.
        Glutamine utilization by the small intestine.
        Adv. Enzymol. 1982; 53: 202
        • Zeilke R.H.
        • Ozand P.T.
        • Tildon J.T.
        • et al.
        Reciprocal regulation of glucose and glutamine utilization by cultured human diploid fibroblasts.
        J. Cell. Physiol. 1978; 95: 41